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The self-assessed threshold temperature for cold in the workplace is not well known. We asked 392 chicken industry workers in Thailand what they regard as the cold threshold (CT) and compared subgroups of workers using linear and quantile regressions by CT sextiles (percentiles P₁₇, P₃₃, P₅₀, P₆₇, and P₈₃, from warmest to coldest). The variables of interest were sex, office work, and sedentary work, with age, clothing thermal insulation, and alcohol consumption as adjustment factors. The mean CT was 14.6 °C. Office workers had a 6.8 °C higher mean CT than other workers, but the difference ranged from 3.8 °C to 10.0 °C from P₁₇ to P₈₃. Sedentary workers had a 2.0 °C higher mean CT than others, but the difference increased from 0.5 °C to 3.0 °C through P₁₇–P₈₃. The mean CT did not differ between sexes, but men had a 1.6–5.0 °C higher CT at P₁₇–P₅₀ (>20 °C) and a 5.0 °C lower CT at P₈₃ (<10 °C). The CT was relatively high at warm (≥10 °C), dry (relative humidity <41%), and drafty (air velocity > 0.35 m/s) worksites. We conclude that office, sedentary, and female workers and those working at warm, dry, and draughty sites are sensitive to the coldest temperatures, whereas male workers are sensitive even to moderate temperatures.

There is ample evidence regarding positive health effects of cycling or walking to work (active commuting [AC]). However, little is known about the effects of AC on work ability. Therefore, we examined 422 Thai chicken meat industry workers who assessed their current work ability (CWA) compared to their lifetime best by assigning scores ranging from 0 to 10. The CWA was compared between active and non-active commuters using linear regression, cumulative distributions, and quantile regression. Overall, 46 workers (11%) were active commuters. The average CWA score was 8.2 (standard deviation, 1.3; range, 4–10). It was higher by 0.5 units (95% confidence interval: 0.2–0.8) in active commuters. Cumulative distributions showed higher CWA scores among active commuters throughout the CWA scale, with the greatest difference (one CWA unit) at scores of 8–9. This benefit of AC persisted after adjustments and was observed at the 33rd, 50th, and 67th percentiles of CWA but not at percentiles higher or lower than the aforementioned ones. The model-predicted CWA scores for selected combinations of personal and work-related factors were up to two units higher among active commuters. In conclusion, active commuters have better work ability than non-active commuters. However, the potential effects may be limited to workers with good work ability. Relevance to the industry: Since commuting is a necessary daily activity for most of the working population, AC may offer great potential to produce positive effects on work ability and health. AC should be encouraged and included in health promotion programs at national and organizational levels.

This paper examines whether the anomalous summer peak in deaths from coronary heart disease (CHD) in Finland could be attributed to adverse effects of the Midsummer festival and alcohol consumption during the festival. Daily deaths from CHD and alcohol poisoning in Finland, 1961–2014, that occurred during the 7 days centering on Midsummer Day were analysed in relation to deaths during 14 to 4 days before and 4 to 14 after Midsummer Day. Daily counts of deaths from CHD among persons aged 35–64 years were regressed on days around the Midsummer period by negative binomial regression. Mortality from CHD was highest on Midsummer Day (RR 1.25 (95% confidence interval 1.12–1.31), one day after the peak in deaths from alcohol poisonings. RR for CHD on Midsummer Day was particulary high (RR = 1.43; 1.09–1.86) in the 2000s, 30% of deaths being attributable to that day. In conclusion, the anomalous and prominent summer peak in deaths from CHD in Finland is an adverse consequence of the Midsummer festival. The most likely underlying reason is heavy alcohol consumption during the festival period, especially on Midsummer Eve. In the 2000s, one third of deaths from CHD on Midsummer Day are preventable.

Background: During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38–41°C to 42–44°C. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work–rest regimen. This study examined whether the present standard still protects most workers. Methods: The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants’ workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. Results: Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ≤ 38.5°C, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44–2.48) in odds for having symptoms. Conclusion: Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.

Background: Recently, the importance of light physical activity (LPA) for health has been emphasized, and residential greenness has been positively linked to the level of LPA and a variety of positive health outcomes. However, people spend less time in green environments because of urbanization and modern sedentary leisure activities. Aims: In this population-based study, we investigated the association between objectively measured residential greenness and accelerometry measured physical activity (PA), with a special interest in LPA and gender differences. Methods: The study was based on the Northern Finland Birth Cohort 1966 (5433 members). Participants filled in a postal questionnaire and underwent clinical examinations and wore a continuous measurement of PA with wrist-worn Polar Active Activity Monitor accelerometers for two weeks. The volume of PA (metabolic equivalent of task or MET) was used to describe the participant’s total daily activity (light: 2–3.49 MET; moderate: 3.5–4.99 MET; vigorous: 5–7.99 MET; very vigorous: ≥8 MET). A geographic information system (GIS) was used to assess the features of each individual’s residential environment. The normalized difference vegetation index (NDVI) was used for the objective quantification of residential greenness. Multiple linear regression and a generalized additive model (GAM) were used to analyze the association between residential greenness and the amount of PA at different intensity levels. Results: Residential greenness (NDVI) was independently associated with LPA (unadjusted β = 174; CI = 140, 209) and moderate physical activity (MPA) (unadjusted β = 75; CI = 48, 101). In the adjusted model, residential greenness was positively and significantly associated with LPA (adjusted β = 70; CI = 26, 114). In men, residential greenness was positively and significantly associated with LPA (unadjusted β = 224; CI = 173, 275), MPA (unadjusted β = 75; CI = 48, 101), and moderate to vigorous physical activity (

Symptoms perceived in cold weather reflect physiological responses to body cooling and may worsen the course of a pre-existing disease or precipitate disease events in ostensibly healthy individuals. However, the associations between cold-related symptoms and their health effects have remained unknown. We examined whether cold-related cardiac and respiratory symptoms perceived in cold weather predict future morbidity and mortality. Methods: Cold-related symptoms were inquired in four national FINRISK surveys conducted in 1997, 2002, 2007, 2012 in Finland including altogether 17 040 respondents. A record linkage was made to national hospital discharge and cause-of-death registers. The participants were followed up until the first hospital admission due to a cardiovascular or respiratory disease or death, or until the end of 2015. The individual follow-up times ranged from 0 to 18 years (mean 11 years). The association of cold-related symptoms with morbidity and mortality was examined by Kaplan-Meyer and Cox-regression analyses. Results: Cold-related cardiac [hazard ratio (HR), 1.76 and its 95% confidence interval (95% CI), 1.44–2.15] and combined cardiac and respiratory symptoms [1.50 (1.29–1.73)] were associated with hospitalization due to cardiovascular causes. The respective HRs for admissions due to respiratory causes were elevated for cold-related respiratory [1.22 (1.07–1.40)], cardiac [1.24 (0.88–1.75)] and cardiorespiratory [1.82 (1.50–2.22)] symptoms. Cold-related cardiorespiratory symptoms were associated with deaths from all natural [1.38 (1.11–1.72)], cardiovascular [1.77 (1.28–2.44)] and respiratory [2.19 (0.95–5.06)] causes. Interpretation: Cold weather-related symptoms predict a higher occurrence of hospital admissions and mortality. The information may prove useful in planning measures to reduce cold-related adverse health effects.

Objective: To test whether homicides in Finland vary according to moon phases. Design: A time series study. Setting: Finland. Participants: 6808 homicides committed in 1961–2014. Outcome: Daily numbers of homicides. Method: The daily numbers of homicides were related to eight moon phases and the illuminated percentage of the moon disc using negative binomial regression. To identify lunar patterns, piecewise linear terms of lunar days were used, together with changes from one moon phase to another. Homicides were similarly regressed on quintiles of the illuminated percentage of the moon disc. A periodic term of length 29.53 days was included to detect cyclic patterns. The results were adjusted for sex, age, secular trend, distance from the moon, seasons, weekday, major holidays and temperature. Results: During the full moon, 15% less homicides were committed than during the new moon (RR 0.85; 95% CI 0.77 to 0.94) and 86% less during the lightest quintile of illumination compared with the darkest quintile (RR 0.14; 95% CI 0.04 to 0.50). Adjustments did not change the results. Piecewise linear regressions showed a significant decline in homicides at the full moon and a rise thereafter. The full moon drop in homicides was directionally similar for seasons, weekdays, sex, age and time periods, and it was particularly pronounced in the early part of period studied (1961–1974). Periodic regression showed a regular cyclic pattern of length 29.53 days (p~0.035). Conclusions: Contrary to current scientific opinion, an association exists between moon phases and homicides, and contrary to what has been previously assumed, homicides declined during the full moon, especially in earlier decades. However, the causality of the association remains elusive.

Background: The temporal sequence in which allergic sensitization to different allergens emerges is not well characterized at the level of general population. Objective: We describe the incidence patterns of atopic sensitization to different allergens from birth up to 12 years of age in an unselected Finnish population. Methods: The study population comprised all children born between 2001 and 2006 identified from the nationwide population register as residents of the province of South Karelia, Finland (n = 5564). The results of allergy tests (22,380 results from skin prick tests, immunoglobulin E [IgE] antibodies, and open food challenges [OFCs], performed in 1827 children) were collected from patient records of all the health care units in the area. Results: The incidence rates of positive results for food and animal allergens as well as positive OFCs for cow’s milk showed prominent peaks at 5 months of age. Positive results for pollen allergens started to emerge after 1.5 years of age. The 12-year cumulative incidence of sensitization to food, animal, pollen, and any allergens was 12%, 8%, 10%, and 18%, respectively. The cumulative incidence of sensitization to house dust mites was 1% and to molds or latex less than 1%. Firstborn boys had the highest, and those who were not firstborn girls and children born in rural municipalities had the lowest early incidence of sensitization to inhalation allergens. Conclusion: In the unselected population, the atopic sensitization against food and animal allergens began before 6 months of age and was followed by sensitization to pollen allergens before 2 years of age. Primary prevention of sensitization to food and inhalation allergens should therefore occur in early infancy.

The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25–74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95% confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12%. It increased with age, from 3% at the age of 25 years to 28% at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01–5.13) and cardiovascular diseases (OR 2.27; 1.78–2.89); being a pensioner (OR 2.91; 1.65–5.28), unemployed (OR 2.82; 1.47–5.48), or working in agriculture (OR 2.27; 1.14–4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31–3.05); being female (OR 1.94; 1.51–2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02–3.32); undertaking hard vs light physical work (OR 1.48;1.06–2.07); and being inactive vs active in leisure time (OR 1.97; 1.39–2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61% depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

The aim of the South Karelian Allergy Research Project (SKARP) was to quantify the occurrence of children’s food allergy and food-associated hypersensitivity symptoms and their associated factors. The study population comprised all children born between April 2001 and March 2006 and living in the province of South Karelia, in the south-eastern part of Finland. The questionnaire survey was conducted in co-operation with the child health clinics in the area in 2005–2006. Concurrently with but independently of the questionnaire study, the results of allergy tests regarding the same child population were collected from patient records. The participation rates in the questionnaire study were 54% (644/1194) among the newborn infants and 69% (3308/4779) among the children aged 1 to 4 years. The lifetime prevalence of parent-reported food allergies was 9% and that of parent-perceived food-associated hypersensitivity symptoms 21% by the age of 4 years. In addition, another 19% of children adhered to an elimination diet without previous symptoms associated with any food items. The prevalence of children with such diets decreased by age. Up to the age of 4 years, 19% of the participants had undergone a food allergy test and 8% of the participants had obtained a positive result in these tests. Physician-diagnosed food allergies and food allergies based on the tests were more common for milk, egg and cereals than for other food items. The tested children and those with a positive test result were only slightly overrepresented among the participants. Allergic manifestations in either biological parent doubled and in both biological parents tripled the incidence of a positive food allergy test. The spring season coinciding with the end of the first trimester of pregnancy predicted sensitisation to food items in the children. In early childhood, food allergies and food hypersensitivities were found to be common in a child population. New population-based knowledge re, Tiivistelmä Etelä-Karjalan allergiatutkimus (EKAT) käynnistettiin selvittämään lasten ruoka-allergioiden ja ruokayliherkkyysoireiden esiintyvyyttä ja niihin liittyviä tekijöitä. Tutkimusväestöön kuuluivat kaikki ne Etelä-Karjalan maakunnan alueella asuvat lapset, jotka olivat syntyneet huhtikuun 2001 ja maaliskuun 2006 välisenä aikana. Kyselyaineisto kerättiin yhteistyössä alueen neuvoloiden kanssa vuosina 2005–2006. Kyselytutkimuksen kanssa samanaikaisesti mutta siitä riippumattomasti kerättiin samaa lapsiväestöä koskevat allergiatestitulokset alueen potilasrekistereistä. Kyselytutkimuksen osallistumisaste oli vastasyntyneiden ikäluokassa 54 % (644/1194) ja isommilla lapsilla 69 % (3308/4779). Kolmannen ikävuoden loppuun mennessä vanhemmat ilmoittivat 9 %:lla lapsista todetun ruoka-allergiaa ja lisäksi 21 %:lla ruokayliherkkyys perustui ainoastaan vanhempien havaintoihin. Näiden lisäksi 19 % lapsista vältti yhtä tai useampaa ruoka-ainetta ilman, että minkään ruoka-aineen olisi todettu aiheuttaneen oireita. Dieettien noudattajien osuus väheni selvästi tarkasteltaessa ikäluokkia yksivuotiaista neljävuotiaisiin. Kolmannen ikävuoden loppuun mennessä ruoka-allergiatestattuja oli 19 % ja positiivisen testituloksen saaneita 8 % tutkimukseen osallistuneista. Lääkärin toteamat ja testeihin perustuneet ruoka-allergiat olivat tavallisempia maidolle, kananmunalle ja viljoille kuin muille ruoka-aineille. Allergiatestatuilla ja positiivisen testituloksen saaneilla oli vain lievä yliedustus kyselytutkimukseen osallistujien joukossa verrattuna kyselyyn vastaamattomiin. Allergiset sairaudet toisella biologisella vanhemmalla kaksinkertaistivat ja molemmilla vanhemmilla kolminkertaistivat positiivisen ruoka-allergiatestin ilmaantuvuuden. Raskauden ensimmäisen kolmanneksen lopun ajoittuminen kevääseen ennakoi syntyvän lapsen herkistymistä ruoka-aineille. Varhaislapsuuden ruoka-allergioiden ja -yliherkkyyksien todettiin olevan tavallisia väestös